大容量全肺灌洗治疗肺泡蛋白沉积症临床疗效观察.docVIP

大容量全肺灌洗治疗肺泡蛋白沉积症临床疗效观察 　　[摘要] 目的 评价大容量全肺灌洗(WLL)治疗肺泡蛋白沉积症(PAP)的临床疗效。方法 对我院21例PAP患者采用WLL进行治疗。结果 所有患者灌洗术后呼吸困难明显改善,体质体力增强。X线或CT检查显示病灶明显吸收。患者每次单侧肺灌洗总量为(8.15±1.56)L,回吸收量为(8.09±1.71)L,灌洗液回收量约98%,回收量、尿量与灌入量基本相符,无一例出现术中、术后肺水肿及其他并发症。灌洗治疗后动脉血氧分压(PaO2)和血氧饱和度(SpO2)明显升高,PaO2和SpO2与灌洗前比较,差异有统计学意义(P0.05)。灌洗治疗后患者FVC、MMV、DLCO、FEV1/ FVC等指标均有显著改善,与灌洗前比较,差异有统计学意义(P0.05)。结论 PAP虽然少见,但只要提高认识,诊断并不困难,且一经确诊,即应尽早施行WLL治疗,WLL不仅安全有效,且疗效巩固持久,可明显改善患者的生活质量,改善预后。 　　[关键词] 肺泡蛋白沉积症;大容量;全肺灌洗 　　[中图分类号] R563.9[文献标识码] A[文章编号] 1673-9701(2010)14-28-02 　　 　　Large Volume Whole Lung Lavage Treatment Pulmonary Alveolar Proteinosis Clinical Observation 　　LIU Ying 　　First Peoples Hospital of Guangyuan,Guangyuan 628017,China 　　 　　[Abstract] Objective Discuss large volume whole lung lavage treatment pulmonary alveolar proteinosis Clinical. Methods 21 cases of PAP patients were treated by WLL in our hospital. Results all patients breathing difficulties were improved significantly after treatment,enhanced physical strength. X ray and CT examination showed significant absorption of lesions. patients each unilateral lung lavage total was 8.15±1.56 L,back to the absorption capacity was 8.09±1.71L,fluid recovery of about 98%,recycling volume,urine volume and poured into the basic line,there was no intraoperative and postoperative pulmonary edema and other complications. Lavage and blood oxygen saturation of arterial partial pressure of oxygen increased significantly after treatment. PaO2 and SaO2 compared with before lavage,the difference was statistically significant(P0.05). patient’s FVC,MMV,DLCO,FEV1/FVC were significant improvements in other indicators after treatment,the difference was statistically significant(P0.05). Conclusion PAP is a rare,but as long as to raise awareness,diagnosis is not difficult,once diagnosed,should implementation WLL treatment early,WLL is not only safe and effective,and the effect of firm and lasting,can significantly improve patients quality of life and improve prognosis. 　　[Key